WHO warns countries not to underestimate pandemic virus

Nov 5, 2009 (CIDRAP News) –An official from the World Health Organization (WHO) today said he expects serious cases and deaths as pandemic flu activity picks up in the Northern Hemisphere, and he warned people not to underestimate the virus, even though illnesses are often mild.

At a media briefing today, Keiji Fukuda, MD, special adviser on pandemic flu to the WHO director-general, said virus activity remains at high levels in the United States, where fall activity has already exceeded the peak of some of the worst winter seasonal flu outbreaks, and in Mexico, where the number of illnesses has topped the country’s spring outbreak.

Flu activity is picking up across European countries such as the Ukraine, "where clearly they are seeing high levels of infections," Fukuda said. Countries in eastern Asia, such as Mongolia, are seeing rising pandemic flu case numbers. He said earlier this fall the seasonal H3N2 virus was common in some parts of eastern Asia, but as the pandemic H1N1 strain becomes dominant, the numbers of H3N2 viruses in those regions are decreasing.

Fukuda said the self-limiting nature of many pandemic H1N1 illnesses has led some people to dismiss the seriousness of the outbreak. He said that though transmission and pathogenicity of the pandemic virus seems to resemble seasonal flu, other features clearly distinguish the two. He emphasized that serious illnesses and deaths are concentrated in people younger than age 65, a pattern not seen with seasonal flu.

"At the WHO we’re concerned about a sizeable number of serious complications and deaths," he said. "In some countries the number of serious cases can put pressure on intensive care units, and people in health systems should take this into account during their planning."

Over the past few weeks more than 20 countries have launched pandemic H1N1 vaccine campaigns, he said. “We see that they [the vaccines] are very safe, with only local pain and redness at the injection site at levels that are similar or sometimes even lower than the seasonal flu vaccine, he added.

The WHO is working to free up as much vaccine as possible, but so far, none has arrived in developing countries, he said. Eleven countries and four vaccine companies have pledged200 million doses, which will go to 95 countries that could not otherwise buy their own supply,

Though the WHO's vaccine advisory group recently recommended that most groups receive only one dose of pandemic vaccine, including children younger than 10 in countries that have prioritized them, Fukuda said the WHO is mindful that more studies on optimal dosage will be coming out over the next several months. He said the WHO’s recommendations may adapt and change, based on new information.

US officials recently released new pandemic vaccine clinical trial data that reaffirmed a two-dose regimen in children under age10.

In the Ukraine, the country’s laboratory experts along with WHO experts have so far found no evidence of worrisome mutation in the pandemic virus isolated from sick patients in the western part of the country. That region has seen dramatically increased virus activity over the past few weeks. However, Fukuda said the virus is still undergoing further characterization at the WHO collaborating center in London.

Today the WHO's regional office in Europe issued a statement that said a five-member WHO team arrived in the Ukraine's western Lviv region, where 100,000 people are reportedly sick with flulike illness. The WHO scientists are visiting some of the affected areas, interviewing medical staff, and talking to patients. They will spend several days in Lviv before traveling to other sites.

The Ukrainian health ministry said today it has receive reports of 633,877 acute respiratory illnesses since Oct 29, including 95 pneumonia deaths, the National News Agency of Ukraine reported.

So far 15 cases of pandemicH1N1 flu have been confirmed, and two deaths from the virus have been reported in Kiev, according to a report today from the National Radio Company of Ukraine that quoted the health ministry.